A 3-month-old is brought with irritability, vomiting and a bulging fontanelle. He has no fever. The eye examination shows retinal haemorrhages, a CT scan shows subdural haematomas, and X-rays show healing posterior rib fractures. The most likely cause is:

Abusive head trauma (shaken baby)

A 12-year-old girl on the ward tells the nurse that an uncle has been sexually abusing her. Her parents beg the nurse to keep it within the family. Under the POCSO Act, the nurse must:

Report it to the police or Special Juvenile Police Unit

Keep it confidential as the parents have requested

Wait until the girl gives written consent to report

Inform only the girl's school counsellor about it

For an 8-year-old with primary nocturnal enuresis, which treatment has the best long-term cure rate?

An enuresis alarm (bell and pad)

Desmopressin tablets at bedtime

Under Rashtriya Bal Swasthya Karyakram, children from birth to 18 years are screened for the 4 Ds, which are:

Defects at birth, diseases, deficiencies and developmental delays

Disability, deformity, dental caries and dwarfism

Diarrhoea, diphtheria, dengue and dehydration

Deafness, dyslexia, depression and drug abuse

In the clinic waiting area, a 2-year-old screams and throws himself on the floor after being refused a toy. The nurse's best advice to the mother is to:

Keep the child safe and calmly ignore the outburst

Give the toy at once so the screaming stops

Promise a sweet if the child stops crying

Scold the child firmly in front of others

Child behaviour, psychiatry and child welfare

10 AIIMS NORCET (Nursing Officer) practice questions on Child behaviour, psychiatry and child welfare, part of Paediatric Nursing. The first 10 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Hard
A 3-month-old is brought with irritability, vomiting and a bulging fontanelle. He has no fever. The eye examination shows retinal haemorrhages, a CT scan shows subdural haematomas, and X-rays show healing posterior rib fractures. The most likely cause is:
1. AA fall from a low bed
2. BCongenital hydrocephalus
3. CBacterial meningitis
4. DAbusive head trauma (shaken baby)
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Answer: D · Abusive head trauma (shaken baby)
Subdural haematomas and retinal haemorrhages without a matching history in a young infant are typical of abusive head trauma, caused by violent shaking. Posterior rib fractures occur when the chest is squeezed hard, and healing fractures show earlier injury. The nurse documents findings exactly, keeps the infant safe and follows the hospital's child-protection reporting procedure. The history given by carers often does not match the injuries.
- A: A short fall rarely causes subdural haematoma with retinal haemorrhage and never posterior rib fractures.
- B: Hydrocephalus develops slowly and does not cause retinal haemorrhages or fractures.
- C: Meningitis usually causes fever and does not explain rib fractures.
Question 2 · Hard
A 12-year-old girl on the ward tells the nurse that an uncle has been sexually abusing her. Her parents beg the nurse to keep it within the family. Under the POCSO Act, the nurse must:
1. AKeep it confidential as the parents have requested
2. BWait until the girl gives written consent to report
3. CReport it to the police or Special Juvenile Police Unit
4. DInform only the girl's school counsellor about it
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Answer: C · Report it to the police or Special Juvenile Police Unit
Section 19 of the POCSO Act requires any person who knows or suspects that an offence has been committed against a child to report it to the Special Juvenile Police Unit or the local police. Section 21 makes failure to report a punishable offence. The duty is not cancelled by a family's request or by the child's reluctance. The nurse also documents the child's words, informs the doctor and ensures medical care and support.
- A: Family wishes do not override the legal duty to report.
- B: The duty to report does not depend on the child's written consent.
- D: Telling a school counsellor does not meet the legal duty to report to police.
Question 3 · Medium
For an 8-year-old with primary nocturnal enuresis, which treatment has the best long-term cure rate?
1. AAn enuresis alarm (bell and pad)
2. BDesmopressin tablets at bedtime
3. CWaking the child every hour
4. DImipramine tablets at night
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Answer: A · An enuresis alarm (bell and pad)
The enuresis alarm sounds at the first drops of urine, and with time the child learns to wake to a full bladder. It needs 2-3 months of consistent use but gives the lowest relapse rate. Desmopressin works quickly and suits camps or sleepovers, but relapse is common after stopping. Punishment is avoided, and the child takes part in changing the sheets without blame.
- B: Desmopressin acts fast but most children relapse when it stops.
- C: Hourly waking disturbs sleep and does not train the child to wake to the bladder.
- D: Imipramine has cardiac toxicity and a high relapse rate, so it is now rarely used.
Question 4 · Medium
Under Rashtriya Bal Swasthya Karyakram, children from birth to 18 years are screened for the 4 Ds, which are:
1. ADisability, deformity, dental caries and dwarfism
2. BDefects at birth, diseases, deficiencies and developmental delays
3. CDiarrhoea, diphtheria, dengue and dehydration
4. DDeafness, dyslexia, depression and drug abuse
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Answer: B · Defects at birth, diseases, deficiencies and developmental delays
RBSK, launched under the National Health Mission in 2013, provides child health screening and early intervention services. Mobile health teams screen children at Anganwadi centres and government schools for defects at birth, diseases, deficiencies and developmental delays including disability. Newborns are screened at delivery points. Children needing care are referred to District Early Intervention Centres.
- A: These are examples within the groups, not the 4 Ds themselves.
- C: These are infections and their effects, not the RBSK screening groups.
- D: Some of these fall under the groups, but this is not the 4 D list.
Question 5 · Medium
In the clinic waiting area, a 2-year-old screams and throws himself on the floor after being refused a toy. The nurse's best advice to the mother is to:
1. AGive the toy at once so the screaming stops
2. BKeep the child safe and calmly ignore the outburst
3. CPromise a sweet if the child stops crying
4. DScold the child firmly in front of others
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Answer: B · Keep the child safe and calmly ignore the outburst
Temper tantrums are normal at this age, when a toddler wants independence but lacks words to express frustration. The parent keeps the child safe and stays calm, without giving attention to the outburst. Giving in or offering rewards teaches the child that tantrums work. Praise is given when the child calms down.
- A: Giving in rewards the tantrum and makes it more frequent.
- C: Bribing the child also rewards the tantrum.
- D: Public scolding gives attention and adds shame without teaching control.
Question 6 · Hard
An 18-month-old walks and climbs well and has normal hearing on testing. He does not point to show things, does not respond to his name, makes little eye contact and spends hours lining up toy cars. The most likely diagnosis is:
1. AGlobal developmental delay
2. BAutism spectrum disorder
3. CIsolated expressive language delay
4. DAttention deficit hyperactivity disorder
Answer and explanation in LearnFree account
Question 7 · Medium
A 7-year-old with ADHD is started on methylphenidate. The nurse advises giving it in the morning, after breakfast, because the drug commonly causes:
1. ALow blood pressure and fainting
2. BBedwetting and dry mouth
3. CInsomnia and a poor appetite
4. DDrowsiness and weight gain
Answer and explanation in LearnFree account
Question 8 · Easy
Bedwetting is diagnosed as nocturnal enuresis only when it continues beyond the age of:
1. A2 years
2. B3 years
3. C7 years
4. D5 years
Answer and explanation in LearnFree account
Question 9 · Easy
Which Indian law deals specifically with sexual offences against persons below 18 years of age?
1. APOCSO Act, 2012
2. BChild Labour Act, 1986
3. CJuvenile Justice Act, 2015
4. DPCPNDT Act, 1994
Answer and explanation in LearnFree account
Question 10 · Easy
The core features of autism spectrum disorder are:
1. AInattention with hyperactivity and impulsive behaviour
2. BLow intelligence with delay in all motor milestones
3. CPersistent defiance and anger towards authority figures
4. DSocial communication deficits with restricted, repetitive behaviour
Answer and explanation in LearnFree account

Child behaviour, psychiatry and child welfare

A 3-month-old is brought with irritability, vomiting and a bulging fontanelle. He has no fever. The eye examination shows retinal haemorrhages, a CT scan shows subdural haematomas, and X-rays show healing posterior rib fractures. The most likely cause is:

A 12-year-old girl on the ward tells the nurse that an uncle has been sexually abusing her. Her parents beg the nurse to keep it within the family. Under the POCSO Act, the nurse must:

For an 8-year-old with primary nocturnal enuresis, which treatment has the best long-term cure rate?

Under Rashtriya Bal Swasthya Karyakram, children from birth to 18 years are screened for the 4 Ds, which are:

In the clinic waiting area, a 2-year-old screams and throws himself on the floor after being refused a toy. The nurse's best advice to the mother is to:

An 18-month-old walks and climbs well and has normal hearing on testing. He does not point to show things, does not respond to his name, makes little eye contact and spends hours lining up toy cars. The most likely diagnosis is:

A 7-year-old with ADHD is started on methylphenidate. The nurse advises giving it in the morning, after breakfast, because the drug commonly causes:

Bedwetting is diagnosed as nocturnal enuresis only when it continues beyond the age of:

Which Indian law deals specifically with sexual offences against persons below 18 years of age?

The core features of autism spectrum disorder are: